冠心病心力衰竭气虚血瘀证严重程度与生物学指标的相关性  

Correlations Between Severity of Heart Failure Related to Coronary Heart Disease of Qi Deficiency and Blood Stasis Syndrome and Biological Indexes

作　　者：卫靖靖 李彬[2] 彭广操[2] 王新陆[2] 赵齐飞 王建茹 于瑞[2] 王永霞[2] 朱明军[2] WEI Jing-jing;LI Bin;PENG Guang-cao;WANG Xin-lu;ZHAO Qi-fei;WANG Jian-ru;YU Rui;WANG Yong-xia;ZHU Ming-jun(Henan University of Chinese Medicine,Zhengzhou 450000,China;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]河南中医药大学,郑州450000 [2]河南中医药大学第一附属医院,郑州450000

出　　处：《中国实验方剂学杂志》2021年第19期97-103,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划“中医药现代化研究”重点专项(2019YFC1710000,2019YFC1710003);国家重点基础研究发展计划项目(2015CB554401);国家中医药管理局中医药循证能力建设项目(2019XZZX-XXG003);河南省高校科技创新团队支持计划项目(13IRTSTHN012)。

摘　　要：目的:探讨冠心病心力衰竭气虚血瘀证严重程度与心功能指标、能量代谢指标、凝血功能指标、炎性因子指标之间的相关性,为冠心病心力衰竭气虚血瘀证的生物学基础研究提供科学依据。方法:连续收集200例冠心病心力衰竭气虚血瘀证患者作为研究组,根据气虚血瘀证评分划为轻、中、重3组,并纳入40例同期健康体检者作为对照组,完成各组心功能指标、能量代谢指标、凝血相关指标及炎性因子等生物学指标的采集。比较各组指标,采用Spearman分析差异指标与气虚血瘀证严重程度的相关性,同时使用有序Logistic回归分析气虚血瘀证严重程度的风险因素。结果:冠心病心力衰竭气虚血瘀证患者存在能量代谢、凝血功能、炎性因子及心功能相关指标的差异,气虚血瘀证轻、中、重3组间N末端B型利钠肽原(NT-ProBNP),6分钟步行试验(6MWT),心肌型-脂肪酸结合蛋白(H-FABP),凝血酶原时间(PT),活化部分凝血活酶时间(APTT),肿瘤坏死因子-α(TNF-α),一氧化氮(NO)水平差异具有统计学意义(P<0.05);气虚血瘀证严重程度与NT-proBNP(r=0.144),PT(r=0.173),APTT(r=0.144)水平呈正相关,与6MWT(r=-0.287)水平呈负相关;6MWT[比值比(OR)=0.995,95%置信区间(CI)0.991~0.998),P<0.01],APTT(OR=1.088,95%CI 1.021~1.157,P<0.01)指标是冠心病心力衰竭气虚血瘀证严重程度的独立影响因素。结论:冠心病心力衰竭气虚血瘀证严重程度与NT-ProBNP,6MWT,H-FABP,PT,APTT,TNF-α,NO指标密切相关,且6MWT,APTT指标可作为独立影响因素,用于评估冠心病心力衰竭气虚血瘀证患者的严重程度。Objective: To explore the correlations of the severity of heart failure related to coronary heart disease arising from Qi deficiency and blood stasis with cardiac function indexes,energy metabolism indexes,coagulation function indexes,and inflammatory factors,in order to provide a scientific basis for further research on the biological foundation of this disease. Method:Two hundred patients with heart failure related to coronary heart disease of Qi deficiency and blood stasis syndrome were collected and then classified into mild,moderate and severe groups according to their scores of Qi deficiency and blood stasis syndrome. Meanwhile,40 healthy persons confirmed by physical examination during the same period were included into the control group.Such biological indexes as cardiac function indexes,energy metabolism indexes,coagulation function indexes,and inflammatory factors were determined in patients of each group for comparison. Then the Spearman rank correlation analysis was conducted to figure out the correlations between differential indexes and the severity of Qi deficiency and blood stasis syndrome,followed by the determination of risk factors for the severity of Qi deficiency and blood stasis syndrome by ordered logistic regression analysis. Result: The cardiac function indexes,energy metabolism indexes,coagulation function indexes,and inflammatory factors in patients with heart failure related to coronary heart disease arising from Qi deficiency and blood stasis varied significantly.There were significant statistical differences in the levels of N-terminal pro-B-type natriuretic peptide(NT-ProBNP),6-minute walk test(6 MWT),heart-type fatty acid-binging protein(H-FABP),prothrombin time(PT),activated partial thromboplastin time(APTT),tumor necrosis factor-α(TNF-α),and nitric oxide(NO)among the mild,moderate,and severe groups(P<0.05). The severity of Qi deficiency and blood stasis syndrome was positively correlated with NT-ProBNP(r=0.144),PT(r=0.173),and APTT(r=0.144),but negatively with 6 MWT(r=-0.287).

关 键 词：冠心病 心力衰竭 气虚血瘀证 生物学指标 相关性 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学]